This project addresses a need for research based data concerning utilization, organization, evaluation, and costs of using commercial temporary nursing personnel. The objective of the 12-month project is to determine and describe nursing service directors perceptions of the use of these personnel in licensed, general acute care hospitals, long-term care facilities, and home health agencies as these perceptions relate to administration and management functions. The goal is to determine nursing service directors perceptions of the effectiveness and efficiency of the use of these personnel and how that use relates to quality of care, cost incurred, morale of permanent staff, and education of student nurses. The specific aim is to conduct a survey of the three above-identified types of institutions in Colorado, Iowa, and Washington. A 3 X 3 X 2 factorial design will be used, i.e. state, type of institution, and administrative control (public, private). A data collection instrument has been developed and pretested for the project. It will solicit information necessary for project's purposes, e.g., factors involved in the decision to use or not use these personnel, costs, orientation practices and procedures, patterns of use, employing institutions' responsibilities, staffing and patient assignments, effects on Quality Assurance Programs and continuity of care, evaluation of these personnel and the care they provide, effect on regular staff morale, overall benefits and limitations, etc. Data will be examined, compared, and analyzed on the basis of the 3 factors above plus number of beds or average number of monthly home visits and population of service area. Appropriate statistical methods will be used and data will be presented in forms to make them as useful and useable as possible. Such data have direct and important applications and implications for quality and costs of health care. They can help nursing administrators plan and manage nursing services more effectively and efficiently.